- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $22,908.68 / $29,512.09
| Facility | | $16,595.87 | $22,908.68 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $28,183.83
| Facility | | $13,803.84 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $23,988.33 / $33,884.42
| Facility | | $12,589.25 | $23,988.33 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $23,442.29 / $28,840.32
| Facility | | $13,803.84 | $23,442.29 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $23,988.33 / $33,884.42
| Facility | | $12,022.64 | $23,988.33 | $33,884.42 |